Salary Data

Medical Grievance and Appeals Nurse Salary

How much does a Medical Grievance and Appeals Nurse make in the United States?
Get the insights on the salary, benefits, education, and job description.
Salary Data for Medical Grievance and Appeals Nurse

$84,210 (USD)/yr

$40 (USD)/hr

$1,474 (USD)/yr

$83,084 (USD)/yr

$40 (USD)/hr

$1,474 (USD)/yr

Job Description
Evaluates and resolves clinical appeals, grievances, and external reviews received from members or providers, including review of pre-service and post-service appeals, utilizing understanding of clinical department operations and claims processing procedures. Communicates and interacts with external partners, including providers, medical groups, Independent Practice Associations, and other external vendors. Reviews medical records related to grievances and appeals, provides monitoring of cases involving medical decisions and quality or care or service, and prepares and performs clinical reviews. Logs grievances and appeals; obtains medical records as needed; and provides clinical reviews, write-ups, and recommendations. Develops correspondence communicating acknowledgement and resolution to enrollees and providers, following appeal time frames. Requires RN license.
The average medical grievance and appeals nurse salary in United States is $84,210 or an equivalent hourly rate of $40. In addition, they earn an average bonus of $1,474. Salary estimates based on salary survey data collected directly from employers and anonymous employees in United States.
Compensation Data Based on Experience

$58,768 (USD)

$104,687 (USD)

Education
Education data not available for this job

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Salary Potential

$97,622 (USD)

16 %

Based on our compensation data, the estimated salary potential for Medical Grievance and Appeals Nurse will increase 16 % over 5 years.

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About The Data
The above data is a sample of data available in ERI's Global Salary Calculator. The Global Salary Calculator provides compensation data for over 45,000 positions in 8,000+ cities in 69 countries. If you need to calculate competitive levels of salaries, incentives and total compensation by industry, organization size and salary planning date, please view a demonstration version of ERI's Salary Assessor, which is used by the majority of the Fortune 500 for salary survey data and compensation planning.
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